The sympatholytic toxidrome is a combination of physical findings that are characteristic of overdose of certain classes of drugs. Beta blockers, calcium-channel blockers, and alpha-2 agonists are associated with this toxidrome.
The primary symptoms of the sympatholytic toxidrome are bradycardia, hypotension, and decreased respiratory rate. Patients may sometimes also present with altered mental status, dry skin, and miosis.
Treatment depends on the particular drug causing the overdose. For example, glucagon and calcium can be given for beta-blocker and calcium-channel blocker overdoses, respectively. IV fluids and vasopressors are frequently used to maintain adequate blood pressure.
Potentially life-threatening emergency
Sympatholytic syndrome
Alerts and Notices
Important News & Links
Synopsis
Codes
ICD10CM:
T44.8X1A – Poisoning by centrally-acting and adrenergic-neuron-blocking agents, accidental (unintentional), initial encounter
SNOMEDCT:
871566007 – Adverse reaction to adrenergic receptor antagonist
T44.8X1A – Poisoning by centrally-acting and adrenergic-neuron-blocking agents, accidental (unintentional), initial encounter
SNOMEDCT:
871566007 – Adverse reaction to adrenergic receptor antagonist
Differential Diagnosis & Pitfalls
- Opioid overdose
- Hypnotic / sedative overdose
- Cholinergic syndrome
- Digoxin toxicity
- Tricyclic antidepressant toxicity
- Cardiogenic shock
Best Tests
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Updated:09/07/2023
Potentially life-threatening emergency
Sympatholytic syndrome